If you missed the first post in this series on healing chronic back pain, check it out here.

So yeah, I did a lot of physical therapy for my chronic low back pain, and it didn’t help. Not a bit. Now I think I know why. It’s not that the PT was bad, though now I’d do things a little differently (more about that in the next installment). The main problem was this: my muscles simply weren’t working right.

Thanks to Tim Ferris’s featuring Muscle Activation Techniques (MAT) in the 4-Hour Body, I had a plan when something shocking happened in Pilates one day.

More Weirdness from My Body

Because I’d already discovered Back Sense by this time, I was living with drastically reduced pain levels and was working to get my life back. So I took advantage of my funky alternative neighborhood and picked up Pilates. I loved it, everything about it.

Except that one day early on, my instructor put me in a lunge position and told me to push the Reformer carriage back with my right leg. I got halfway there and then . . . nothing.

“Is it too heavy?” he asked.

I was flustered. “No, it’s not that. It just . . . stopped. I can’t even feel the muscle anymore.” I tried again with even worse results. Tears stung my eyes. I knew it was silly but I felt humiliated.

He asked me to try with my left leg. No problem–the weight felt light. What on earth was going on???

“That,” he announced, is the clearest case I’ve ever seen of a non-firing muscle.”

He’d said the magic word, “non-firing.” I knew it was time to pursue MAT. I’d been curious about it before, but never motivated to book an appointment. Now I was motivated!

I immediately scheduled a session with Jim Guillory in Houston, TX, and in that first hour, I discovered that almost no muscle in my entire body was contracting correctly. If Jim put a limb into a position to prevent muscle compensation, I had zero strength.

Fortunately, Jim could do more than show me what was wrong; he also could make it right. He got to work restoring function to these muscles. I saw the results immediately. I waltzed back into my Pilates studio the next day and pounded that glute extension!

Over the following weeks, I began to notice the difference between walking with properly firing muscles and walking with “deactivated” muscles. I also noticed a major decrease in my low back pain, as well as the total resolution of a mysterious pain on the front of my right hip that no one (chiropractor, massage therapist, Rolfer, etc.) had been able to improve.

I’ve now been a MAT client for years and have no plans to give it up. Except, of course, that there aren’t any practitioners within a 5 hour radius of my new home. Nice.

So, What’s the Theory Behind MAT?

Let’s start with what a veteran physical therapist told me this August. She said that when she discovered MAT 15 years ago, finally everything made sense:

“You have two patients with identical injuries, torn ACLs. Both are highly compliant. One recovers like clockwork, the other deteriorates. Why? MAT answers that question: You can’t strengthen what you can’t recruit.”

The MAT theory, as I understand it, goes something like this:

For many reasons (overuse, trauma, poor habits, or stress) a muscle may cease to contract efficiently

Other muscles compensate for this under-functioning muscle

This produces unnatural and inappropriate forces applied to joints

Joint and muscle inflammation ensues and causes pain

Sometimes this inflammation can cause more muscles to shut down

And the cycle continues

A lot of muscle tension can be traced back to this under-functioning/over-functioning dynamic

As long as the muscle(s) doesn’t have full neuromuscular connection (i.e., the brain can’t recruit it), any attempts to strengthen it will actually lead instead to strengthening the compensating muscles. The more you strengthen them and improve their compensatory ability, the greater the muscular imbalances become (weak stays weak, strong gets stronger) and the more dysfunction and pain the patient experiences.

The person appears to get stronger, yet they don’t get better.

Oh man, tell me about it! I did all the “right” things with exercise, supervised by well-trained professionals, and with physical therapy, and all I got was this lousy t-shirt.

But How Does It Work?

Well, I’ll say this. Unlike some of my other favorite healing modalities, no one could accuse MAT of being woo woo. It’s as straight-laced as your middle school librarian.

Harrumph.

MAT specialists apply a variety of techniques to coax your nervous system and muscular system back into friendship, and your muscles into greater contracting efficiency. One technique is to use their fingers to stimulate the areas of the muscle that receive neural input. Jim says it’s a way to remind the brain that the muscle is there and available. Or something like that. I can’t pretend to understand it completely, but the difference is unreal.

One minute your muscle can’t withstand any resistance at all; the next it can.

If you have a lot of chiropractic experience, you might be thinking that your chiropractor does this. Perhaps on a small scale. I’ve had chiropractors show me that, say, my hip flexors are weak, then they do an adjustment, and it’s strong again. MAT specialists are far more skilled in muscle work than that—and they can treat the whole body and whole patterns of weakness, inflammation, and pain.

I do think that MAT and chiropractic can make a killer combination, though. Most chiropractors and chiropractic patients overlook the importance of muscular health and function in preserving correct skeletal alignment. Working with both at the same time can provide a more balanced approach.

When Other Things Interfere

Unfortunately, my MAT story isn’t cut and dried. I’m still a MAT client because, well, my muscles don’t stay activated. That’s not normal. Jim tells me that he sees this phenomenon with autoimmune conditions. Stay tuned on that one. I don’t have a diagnosis of one yet, but it’s a possibility.

(It is, however, perfectly normal to have chronically deactivating muscles if you don’t change the habits that may be leading to them. In my case, my habits are not enough to account for the muscle failure.)

What this meant for me is that for several months I saw Jim for 15 minutes per week, every week, to reactivate enough muscles to keep my inflammation levels down. It was like a weekly pain pill. Pricey but worth it. I also quit Pilates. No matter how gently I took it, every session I deactivated something. In fact, I did as little physical activity as possible to avoid triggering the deactivation patterns. (I’d change this approach now if I could do it over, but it’s the best I knew at the time.)

During pregnancy, suddenly all that changed. (Was it the hormone cocktail? The suppressed immune system?) I could work out and get stronger and use the right muscles to do it. Wow. I worked closely with Jim and a trainer at ATC to take baby steps. It was wonderful! I got much stronger and more stable during pregnancy.

But after the baby my body’s back to its old tricks, just dialed down a few notches. Even though my muscles still don’t work right and I’m actively pursuing healing for that problem, at least my pain is now minimal, a result of the third tool that I’ll share in the next installment.

The Seattle PT I mentioned above, however, tells me that MAT techniques have come even further in recent years and that a select 40 practitioners are being trained in the MATRx program, which offers more hope for chronically deactivating people like me. I’m really excited about this possibility and am praying for a way to receive these MATRx treatments! Denver, by the way, is MAT headquarters, a mere 6.5 hour drive away. I’m scheming for sure. Living with joint pain is a drag, especially when the more you exercise, the worse it gets.

That brings me to another thing…

A Word of Caution

As with NAET practitioners, one MAT specialist is not like another. I’ve had spectacular treatment and positively dismal treatment. In the latter case, a MAT fellow in Oklahoma City deactivated more muscles than he fixed. Oy. Not cool. Not cool at all.

So be forewarned. See someone who specializes in MAT, not someone who dabbles in it along with 5 other modalities. Find someone with as much experience as possible, and if you can, find someone through word of mouth or references. Barring that, be willing to shop around.

Here’s the MAT website where you can search for practitioners in your area. Note their date of training (generally, the older the better) and their level (usually the higher the better), and ask questions.

My pain started over four years ago when I took up hot yoga. My health was trending upward, and I finally felt well enough to do more than walk to the end of the block. I loved the yoga. Then the pain started. Then it worsened, despite my using every modification in the book. Finally, I quit yoga.

And then I suffered and suffered and suffered. Nothing except ice and not moving seemed to help.

My low back pain (right sacro-iliac pain, to be specific) was moderately severe–not quite so bad I wanted to die, but severe enough to interfere with every part of my life. Work, play, hobbies, moving, sitting, sleeping, sex, you name it. I was deeply discouraged.

I have fantastic news, though: I only have 5% of that pain left. After trying all the conventional and typical options out there, I finally found three tools that worked wonders.

So what are they?

What Didn’t Work

First, let’s take a look at what didn’t work:

Half a dozen chiropractors and their devices, like a sacro-iliac stabilizing belt (note: chiropractic did help occasional acute neck and back pain, but not my chronic SI pain)

Weeks and weeks of physical therapy (including Feldenkrais), followed by months of continuing the training at home

10 sessions of Rolfing

20+ sessions of acupuncture (although acupuncture did help some other issues of mine)

Pain relievers–ingested and topical (beyond last resort, and I only made it 3 days on them, ugh)

Yeah, I tried a lot over those years of distress. Some of these treatments are perfectly good; they might help others, just not me. Others were not good, not good at all.

Like the crazy side effects I got from the steroid injection–intense hot flashes and night sweats for 2 weeks. You know, typical stuff. (Did I mention the injection didn’t do a darn thing to relieve my pain?) The pain management specialist said my side effects would be expected for someone on their 4th or 5th round of injections, not their first. Steroids are no joke for those of us who are extremely sensitive.